Young adults with mental health problems confront both developmental and institutional transitions. Optimal systems of care for youth coordinate transitions from youth services into adult services. Although youth and adult organizational systems have been examined independently, there is little empirical information available on connections between the two systems. This research project will measure and examine these transition points and bridges. Interorganizational bridges at service transition points are important components of mental health service delivery in the United States. This project will identify organizations providing mental health to young adults (16-25), measure and analyze variations in their attributes, and examine the relationship between organizational attributes and the nature, structure, and variation among interorganizational bridges. This project will be one of the first to specifically examine organizational transition structures between child and adult systems of care, illuminating the pathways for young people at risk of exiting from care when they are epidemiologically most at risk of major mental disorder. This project will survey the population of organizations in the St. Louis region providing mental health services to youth with severe emotional disturbances and/or young adults with serious mental illnesses. Key informants within provider organizations will be asked to provide organizational information, interorganizational network relationships, and descriptive organizational performance data. Research will examine coordination and continuities between youth and adult mental health services in detail, collecting attributional and relational data on coordination and structural continuities. Case management, transition planning, and referral networks will indicate the presence and extent of pathways from youth to adult service systems. Organizational variation in the use of these bridging mechanisms at service transition points will be the subject of analysis. This project will accomplish three goals. First, research will identify interorganizational patterns that promote continuity of care, foster therapeutic alliances, and prevent discontinuities or gaps which can dissuade or impede persons in need of mental health care. Second, it will examine and model variation in organizational performance measures (including specific services for transition planning). Third, this project will examine the association between organizational attributes, structural location within and between youth or adult systems, and organizational performance. Results will suggest ways in which planned transitions and coordinated development of organizational bridges will improve the accessibility availability, quality, coordination, and effectiveness of mental health care for young adults.